As of February 2020, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreak started in China in December 2019 has been spreading in many countries in the world. With the numbers of confirmed cases are increasing, information on the epidemiologic investigation and clinical manifestation have been accumulated. However, data on viral load kinetics in confirmed cases are lacking. Here, we present the viral load kinetics of the first two confirmed patients with mild to moderate illnesses in Korea in whom distinct viral load kinetics are shown. This report suggests that viral load kinetics of SARS-CoV-2 may be different from that of previously reported other coronavirus infections such as SARS-CoV.
China ; Coronavirus ; Coronavirus Infections ; Humans ; Kinetics ; Korea ; SARS Virus ; Severe Acute Respiratory Syndrome ; Viral Load

Coronavirus Infections ; epidemiology ; Humans

OBJECTIVE: To systematically summarize the clinical features of coronavirus disease 2019 (COVID-19) in children. METHODS: PubMed, Embase, Web of Science, The Cochrane Library, CNKI, Weipu Database, and Wanfang Database were searched for clinical studies on COVID-19 in children published up to May 21, 2020. Two reviewers independently screened the articles, extracted data, and assessed the risk of bias of the studies included. A descriptive analysis was then performed for the studies. Related indices between children with COVID-19 and severe acute respiratory syndromes (SARS) or Middle East respiratory syndrome (MERS) were compared. RESULTS: A total of 75 studies were included, with a total of 806 children with COVID-19. The research results showed that the age of the children ranged from 36 hours after birth to 18 years, with a male-female ratio of 1.21 : 1. Similar to SARS and MERS, COVID-19 often occurred with familial aggregation, and such cases accounted for 74.6% (601/806). The children with COVID-19, SARS, and MERS had similar clinical symptoms, mainly fever and cough. Some children had gastrointestinal symptoms. The children with asymptomatic infection accounted for 17.9% (144/806) of COVID-19 cases, 2.5% (2/81) of SARS cases, and 57.1% (12/21) of MERS cases. The children with COVID-19 and MERS mainly had bilateral lesions on chest imaging examination, with a positive rate of lesions of 63.4% (421/664) and 26.3% (5/19) respectively, which were lower than the corresponding positive rates of viral nucleic acid detection, which were 99.8% and 100% respectively. The chest radiological examination of the children with SARS mainly showed unilateral lesion, with a positive rate of imaging of 88.9% (72/81), which was higher than the corresponding positive rate of viral nucleic acid detection (29.2%). Viral nucleic acid was detected in the feces of children with COVID-19 or SARS, with positive rates of 60.2% (56/93) and 71.4% (5/7) respectively. The children with COVID-19 had a rate of severe disease of 4.6% (31/686) and a mortality rate of 0.1% (1/806), the children with SARS had a rate of severe disease of 1.5% (1/68) and a mortality rate of 0%, and those with MERS had a rate of severe disease of 14.3% (3/21) and a mortality rate of 9.5% (2/21). CONCLUSIONS Children with COVID-19 have similar symptoms to those with SARS or MERS, mainly fever and cough. Asymptomatic infection is observed in all three diseases. Children with COVID-19 or SARS have milder disease conditions than those with MERS. COVID-19 in children often occurs with familial aggregation. Epidemiological contact history, imaging examination findings, and viral nucleic acid testing results are important bases for the diagnosis of COVID-19.
Betacoronavirus ; Child ; Coronavirus Infections ; physiopathology ; Cough ; virology ; Female ; Fever ; virology ; Humans ; Male ; Middle East Respiratory Syndrome Coronavirus ; Pandemics ; Pneumonia, Viral ; physiopathology ; Severe Acute Respiratory Syndrome ; physiopathology ; virology

In 2015, there was a Middle East respiratory syndrome (MERS) outbreak in Korea. Interestingly, most of the cases were nosocomial infection and significant numbers of healthcare workers (HCWs) were infected. There were various causes, but this study focused on HCWs and their ability to self-protect from infectious materials. HCWs did not receive sufficient instruction or training on biosafety, including how to use personal protection equipment and risk assessment at the beginning of the outbreak. Previous experience from an outbreak of severe acute respiratory syndrome or Ebola showed that HCWs must self-protect from infection sources, but HCW infection occurred again with this MERS outbreak. Therefore, the concept of biosafety self-protection must be emphasized so that HCWs can protect themselves from diseases and avoid spreading them.
Communicable Diseases, Emerging* ; Coronavirus Infections ; Cross Infection ; Delivery of Health Care ; Humans ; Korea ; Risk Assessment ; Severe Acute Respiratory Syndrome

Betacoronavirus ; Coronavirus Infections ; epidemiology ; transmission ; Disease Outbreaks ; Humans ; Pandemics ; Pneumonia, Viral ; epidemiology ; transmission ; Severe Acute Respiratory Syndrome ; epidemiology

In the twenty-first century, high contagious infectious diseases such as SARS (Severe Acute Respiratory Syndrome), MERS (Middle East Respiratory Syndrome), FMD (Foot-and-Mouth Disease) and AI (Avian Influenza) have become very prevalent, causing treat harm to humans and animals in aspect of public health, and economical issues. The critical problem is that newly-reported infectious diseases that humans firstly experience are expected to continue to emerge, and these diseases will be spreading out rapidly. Therefore, rapid and safe supplies of effective vaccines are most pivotal to prevent the rapid prevalent of new infection, but international standards or assessing protocol the safety of urgent vaccines are not established well. In our previous study, since we established a module to assess the brain safety of urgent vaccines, therefore, it is necessary to verify that this established module for assessing brain safety could work effectively in commercially available two vaccines (one killed- and on live-vaccines). We compared the results of Evans blue (EB) assay and qPCR analysis by injection of two kinds of vaccines, PBS and Lipopolysaccharide (LPS) under the condition of the module previously reported. We confirmed that the brain safety test module for urgent vaccine we established is very reproducible. Therefore, it is believed that this vaccine safety testing method can be used to validate brain safety when prompt supply of a newly developed vaccines is needed.
Animals ; Brain ; Communicable Diseases ; Coronavirus Infections ; Equipment and Supplies ; Evans Blue ; Humans ; Methods ; Public Health ; Severe Acute Respiratory Syndrome ; Vaccines

Coronavirus ; Coronavirus Infections ; epidemiology ; Humans ; Respiratory Tract Infections ; epidemiology

No abstract available.
Coronavirus Infections* ; Disasters* ; Middle East*

No abstract available.
Coronavirus Infections* ; Korea* ; Middle East*

Objective To compare the similarities and differences of early CT manifestations of three types of viral pneumonia induced by SARS-CoV-2 (COVID-19), SARS-CoV (SARS) and MERS-CoV (MERS) using a systemic review. Methods Electronic database were searched to identify all original articles and case reports presenting chest CT features for adult patients with COVID-19, SARS and MERS pneumonia respectively. Quality of literature and completeness of presented data were evaluated by consensus reached by three radiologists. Vote-counting method was employed to include cases of each group. Data of patients' manifestations in early chest CT including lesion patterns, distribution of lesions and specific imaging signs for the three groups were extracted and recorded. Data were compared and analyzed using SPSS 22.0. Results A total of 24 studies were included, composing of 10 studies of COVID-19, 5 studies of MERS and 9 studies of SARS. The included CT exams were 147, 40, and 122 respectively. For the early CT features of the 3 pneumonias, the basic lesion pattern with respect to "mixed ground glass opacity (GGO) and consolidation, GGO mainly, or consolidation mainly" was similar among the 3 groups (=7.966, >0.05). There were no significant differences on the lesion distribution (=13.053, >0.05) and predominate involvement of the subpleural area of bilateral lower lobes (=4.809, >0.05) among the 3 groups. The lesions appeared more focal in COVID-19 pneumonia at early phase (=23.509, <0.05). The proportions of crazy-paving pattern (=23.037, <0.001), organizing pneumonia pattern (<0.05) and pleural effusions (<0.001) in COVID-19 pneumonia were significantly lower than the other two. Although rarely shown in the early CT findings of all three viral pneumonias, the fibrotic changes were more frequent in SARS than COVID-19 and MERS (=6.275, <0.05). For other imaging signs, only the MERS pneumonia demonstrated tree-in-buds, cavitation, and its incidence rate of interlobular or intralobular septal thickening presented significantly increased as compared to the other two pneumonia (=22.412, <0.05). No pneumothorax, pneumomediastinum and lymphadenopathy was present for each group. Conclusions Imaging findings on early stage of these three coronavirus pneumonias showed similar basic lesion patterns, including GGO and consolidation, bilateral distribution, and predominant involvement of the subpleural area and the lower lobes. Early signs of COVID-19 pneumonia showed less severity of inflammation. Early fibrotic changes appeared in SARS only. MERS had more severe inflammatory changes including cavitation and pleural effusion. The differences may indicate the specific pathophysiological processes for each coronavirus pneumonia.
Betacoronavirus ; Coronavirus Infections ; diagnostic imaging ; Humans ; Lung ; diagnostic imaging ; Middle East Respiratory Syndrome Coronavirus ; Pandemics ; Pneumonia, Viral ; diagnostic imaging ; SARS Virus ; Severe Acute Respiratory Syndrome ; diagnostic imaging ; Tomography, X-Ray Computed